Annals of Vascular Surgery

, Volume 3, Issue 1, pp 8–10 | Cite as

Plasma level of the creatine phosphokinase BB isoenzyme during experimental intestinal ischemia

  • Vassilios E. Smirniotis
  • Alexandra T. Labrou
  • Dimitris D. Tsiftses
Original Articles


Changes in the serum of CPK-BB isoenzyme were investigated in dogs with intesti-nal ischemia in order to determine their use as an enzymatic diagnostic test for bowel Infarction. The study consisted of 12 mongrel dogs. Group I (n = 6) was assigned as a control and was subjected to lumen obstruction of a jejunal segment 50–60 cm in length. Group II (n = 6) had an intestinal infarction created by ligation of the arteries of a jejunal segment 50–60 cm in length. A catheter was placed into the right atrium through the left jugular vein for blood sampling and monitoring. Blood samples were withdrawn every three hours for biochemical assays. CPK-BB measurements were performed by electrophoresis in agarose gel. CPK-BB remained unchanged in Group I during the course of the study (median range 17 to 20 IU) showing no significant difference from normal levels. Significant elevation of CPK-BB occurred three hours after establishing the ischemia in Group II (median 50 IU) as compared to Group I (p < 0.05). The highest levels were deter-mined to be 96 and 80 IU at the sixth and ninth hour, respectively. From hour 15 until completion of the experiment, no significant difference was detected between Groups I and II. We conclude that CPK-BB elevation in serum signifies its release from the smooth muscles of the bowel due to ischemic cellular damage.

Key words

Creatine Phosphokinase CPK-BB isoenzyme Intestinal ischemia, experimental 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    OTTINGER LW. The surgical management of acute occlusion of the superior mesenteric artery.Ann Surg 1978;188:721–731.CrossRefPubMedGoogle Scholar
  2. 2.
    FRANTZIDES C, TSIFTSIS D, CONDON ER, STAURAKA A, PISSIOTIS C, PAPADIMITRIOU J. Radionuclide visualization of acute occlusive and non-occlusive intestinal ischemia.Ann Surg 1986;203:295–300.CrossRefPubMedGoogle Scholar
  3. 3.
    GRAEBER GM, CAFFERTY PJ, REARDON MJ, CURLEY PC, ACKERMAN BN, HARMON WJ. Changes in serum total creatine Phosphokinase and its isoenzymes caused by experimental ligation of the superior mesenteric artery.Ann Surg 1981;193:499–505.PubMedGoogle Scholar
  4. 4.
    ITANO M. The detection of a CPKl(BB) in serum: A summary of sixteen cases.Am J Clin Pathol 1976;65:351–355.PubMedGoogle Scholar
  5. 5.
    LAMAR W, WOODWARD L, STATLAND BE. Clinical implications of creatine kinase-BB isoenzyme.N Engl J Med 1978;299:234–235.Google Scholar
  6. 6.
    DORAN GA. Appearance of creatine kinase-BB isoenzyme in serum of a patient suffering from infarction of the colon.Clin Chem Acta 1979;92:415–419.CrossRefGoogle Scholar
  7. 7.
    TSEUNG SM. Creatine kinase isoenzyme pattern in human tissue obtained at surgery.Clin Chem 1976;22:173–175.Google Scholar
  8. 8.
    KLEIN MS, SHELL WE, SOBEL BE. Serum creatine Phosphokinase (CPK) isoenzymes following intramuscular injections, surgery and myocardial infarction: Experimental and clinical studies.Cardiovasc Res 1973;7:412–418.CrossRefPubMedGoogle Scholar
  9. 9.
    ROBERTS R, HENRY PD, WITTEEVAEN AGJS, SOBEL EB. Quantification of serum creatine Phosphokinase isoenzyme activity.Am J Cardiol 1974;33:650–654.CrossRefPubMedGoogle Scholar
  10. 10.
    WILKINSON J, STECIW B. Evaluation of a new procedure for measuring serum creatine kinase activity.Clin Chem 1970;16:370–374.PubMedGoogle Scholar
  11. 11.
    SARR GM, BULKLEY BG, ZUIDEMA GD. Preoperative recognition of intestinal obstruction. Prospective evaluation of diagnostic capability.Am J Surg 1983;145:176–181.CrossRefPubMedGoogle Scholar
  12. 12.
    BARNETT WO, PETRO AB, WILLIAMSON JW. A current appraisal of problems with gangrenous bowel.Ann Surg 1976;83:653–659.CrossRefGoogle Scholar
  13. 13.
    COOPERMAN M. Determination of viability of ischemic intestine by doppler ultrasound.Surgery 1978;83:705–710.PubMedGoogle Scholar
  14. 14.
    ROBERTS R, HENRY PD, SOBEL BE. An improved basis for enzymatic estimation of infarct size.Circulation 1975;52:743–754.PubMedGoogle Scholar
  15. 15.
    ROBERTS R, GOWDAR KS, LUDBROOK PA, SOBEL BE. Specificity of elevated serum MB creatine Phosphokinase activity in the diagnosis of acute myocardial infarction.Am J Cardiol 1975;36:433–437.CrossRefPubMedGoogle Scholar
  16. 16.
    NIELSON L, LUDVIGSEN BJ. Improved method for determination of creatine kinase.J Lab Clin Med 1968;62:159–168.Google Scholar

Copyright information

© Annals of Vascular Surgery Inc. 1989

Authors and Affiliations

  • Vassilios E. Smirniotis
    • 1
  • Alexandra T. Labrou
    • 1
  • Dimitris D. Tsiftses
    • 1
  1. 1.Medical School, Second Department of Surgery, Areteion HospitalAthens UniversityAthensGreece

Personalised recommendations